title: Hypothesizing that brain reward circuitry genes are genetic antecedents of pain sensitivity and critical diagnostic and pharmacogenomic treatment targets for chronic pain conditions.
abstract: While it is well established that the principal ascending pathways for pain originate in the dorsal horn of the spinal cord and in the medulla, the control and sensitivity to pain may reside in additional neurological loci, especially in the mesolimbic system of the brain (i.e., a reward center), and a number of genes and associated polymorphisms may indeed impact pain tolerance and or sensitivity. It is hypothesized that these polymorphisms associate with a predisposition to intolerance or tolerance to pain. It is further hypothesized that identification of certain gene polymorphisms provides a unique therapeutic target to assist in the treatment of pain. It is hereby proposed that pharmacogenetic testing of certain candidate genes (i.e., mu receptors, PENK etc.) will result in pharmacogenomic solutions personalized to the individual patient, with potential improvement in clinical outcomes.
authors.affiliation: Chang Jung Christian University, Tainan, Taiwan, ROC.
authors.forename: Amanda L-C
authors.initials: AL
authors.lastname: Chen
authors.forename: Thomas J H
authors.initials: TJ
authors.lastname: Chen
authors.forename: Roger L
authors.initials: RL
authors.lastname: Waite
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Reinking
authors.forename: Howard L
authors.initials: HL
authors.lastname: Tung
authors.forename: Patrick
authors.initials: P
authors.lastname: Rhoades
authors.forename: B William
authors.initials: BW
authors.lastname: Downs
authors.forename: Eric
authors.initials: E
authors.lastname: Braverman
authors.forename: Dasha
authors.initials: D
authors.lastname: Braverman
authors.forename: Mallory
authors.initials: M
authors.lastname: Kerner
authors.forename: Seth H
authors.initials: SH
authors.lastname: Blum
authors.forename: Nicholas
authors.initials: N
authors.lastname: DiNubile
authors.forename: David
authors.initials: D
authors.lastname: Smith
authors.forename: Marlene
authors.initials: M
authors.lastname: Oscar-Berman
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Prihoda
authors.forename: John B
authors.initials: JB
authors.lastname: Floyd
authors.forename: David
authors.initials: D
authors.lastname: O'Brien
authors.forename: H H
authors.initials: HH
authors.lastname: Liu
authors.forename: Kenneth
authors.initials: K
authors.lastname: Blum
mesh_terms: D000344:Afferent Pathways / Q000502:physiology; D000700:Analgesics / Q000627:therapeutic use*; D001921:Brain / Q000502:physiology*; D004298:Dopamine / Q000502:physiology; D005356:Fibromyalgia / Q000503:physiopathology; D006801:Humans; D009020:Morphine / Q000627:therapeutic use; D009474:Neurons / Q000502:physiology; D009619:Nociceptors / Q000187:drug effects / Q000502:physiology; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy*; D017288:Pain Threshold / Q000502:physiology; D012201:Reward; D013116:Spinal Cord / Q000502:physiology; D013315:Stress, Psychological / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000209:etiology
chemical_list: D000700:Analgesics; D009020:Morphine; D004298:Dopamine